Optimal Pulse Sequence for Ferumoxides-Enhanced MR Imaging Used in the Detection of Hepatocellular Carcinoma: A Comparative Study Using Seven Pulse Sequences.
- Author:
Seung Hoon KIM
1
;
Dongil CHOI
;
Jae Hoon LIM
;
Won Jae LEE
;
Hyun Jung JANG
;
Hyo Keun LIM
;
Soon Jin LEE
;
Jae Min CHO
;
Seung Kwon KIM
;
Gab Chul KIM
Author Information
- Publication Type:Original Article
- Keywords: Liver neoplasms, MR; Iron; Magnetic resonance (MR), contrast enhancement; Magnetic resonance (MR), comparative studies; Receiver operating characteristic(ROC)
- MeSH: Adult; Aged; Carcinoma, Hepatocellular/*diagnosis; Contrast Media; Echo-Planar Imaging; Female; Human; Image Enhancement; Iron/*diagnostic use; Liver Neoplasms/*diagnosis; *Magnetic Resonance Imaging; Male; Middle Age; Oxides/*diagnostic use
- From:Korean Journal of Radiology 2002;3(2):87-97
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To identify the optimal pulse sequence for ferumoxides-enhanced magnetic resonance (MR) imaging in the detection of hepatocelluar carcinomas (HCCs). MATERIALS AND METHODS: Sixteen patients with 25 HCCs underwent MR imaging following intravenous infusion of ferumoxides. All MR studies were performed on a 1.5-T MR system, using a phased-array coil. Ferumoxides (Feridex IV) at a dose of 15 micro mol/Kg was slowly infused intravenously, and axial images of seven sequences were obtained 30 minutes after the end of infusion. The MR protocol included fast spin-echo (FSE) with two echo times (TR3333-8571/TE18 and 90-117), singleshot FSE (SSFSE) with two echo times (TR infinity/TE39 and 98), T2*-weighted gradient-recalled acquisition in the steady state (GRASS) (TR216/TE20), T2*-weighted fast multiplanar GRASS (FMPGR) (TR130/TE8.4-9.5), and T2*-weighted fast multiplanar spoiled GRASS (FMPSPGR) (TR130/TE8.4-9.5). Contrast-to-noise ratios (CNRs) of HCCs determined during the imaging sequences formed the basis of quantitative analysis, and images were qualitatively assessed in terms of lesion conspicuity and image artifacts. The diagnostic accuracy of all sequences was assessed using receiver operating characteristic (ROC) analysis. RESULTS: Quantitative analysis revealed that the CNRs of T2*-weighted FMPGR and T2*-weighted FMPSPGR were significantly higher than those of the other sequences, while qualitative analysis showed that image artifacts were prominent at T2*-weighted GRASS imaging. Lesion conspicuity was statistically significantly less clear at SSFSE imaging. In term of lesion detection, T2*-weighted FMPGR, T2*- weighted FMPSPGR, and proton density FSE imaging were statistically superior to the others. CONCLUSION: T2*-weighted FMPGR, T2*- weighted FMPSPGR, and proton density FSE appear to be the optimal pulse sequences for ferumoxidesenhanced MR imaging in the detection of HCCs.
